Clinical analysis of postoperative pathologic mandibular fractures L. Zhang, Y. Zhang, C.B. Guo, et al.
Journal of Modern Stomatology 2008: 22(5): 449–452
The objective of this study was to summarize the characteristics and key points of treatment on postoperative pathological mandibular fractures. Thirteen consecutive patients with postoperative pathological fractures of the mandible were reviewed. There were 10 males and 3 females with a median age of 54 years. The pathological causes, fracture time and site, the quality of residual bone, as well as treatment methods were analyzed. The most frequent pathogenesis causing postoperative pathological fractures were marginal mandibulectomy, curettage for the giant cystic lesions and osetoradionecrosis. The average residual bone height left following marginal mandibulectomy was 0.78 cm. The pathological fractures of ten patients occurred in less than 6 months postoperatively. The fracture sites were more often found at the back-end of marginal resection and mandible angle. Reduction and internal fixation were performed for 12 patients: miniplates for 5 cases, and reconstruction plates for 7 cases. Three patients with miniplates were re-operated with reconstruction plate for nonunion and osteomyelitis. The results suggested that residual bone height of marginal mandibulectomy should be more than 1.0 cm to prevent future pathologic fractures. The chance of pathological fractures should be taken into consideration when curettage is planned for the giant cystic lesions. Reconstruction plate was the internal fixation of choice for mandibular pathologic fractures.